<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01//EN" "http://www.w3.org/TR/html4/strict.dtd">
<%@page isELIgnored="false" %>
<%@taglib prefix="c" uri="http://java.sun.com/jsp/jstl/core"%>
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
    <title>Send record</title>
    <style type="text/css"><!--
body{font-family:sans-serif; text-align:center;}
div.container{width:520px; text-align:left;}
div.entry {
    clear:both;
}
label {
    width:187px;
    float:left;
    text-align:right;
    padding-top:2px;
    margin-bottom:13px;
    margin-right: 6px;
}
    --></style>
</head>
<body><center>
<div class="container">

    <p>For this demo, select a registered user from the "ringful-demo" app, and send an allergy record to his/her Google Health account.</p>

    <form action="/demo/send" method="post">
        <div class="entry">
            <label>From</label>
            <strong>Ringful Demo</strong>
        </div>
        <div class="entry">
            <label>Demo username</label>
            <select name="username">
                <c:forEach items="${requestScope.users}" var="user">
                <option value="${user}">${user}</option>
                </c:forEach>
            </select>
        </div>
        <div class="entry">
            <label>To</label>
            <select name="to">
                <option value="google" selected="selected">Google Health</option>
                <option value="healthvault">MS Health Vault</option>
                <option value="mayo">Mayo Clinic</option>
                <option value="1health">1 Health Network</option>
                <option value="acme">ACME Diagnostic Lab</option>
            </select>
        </div>
        <div class="entry">
            <label>Allergen name</label>
            <input type="text" name="allergen" value=""/>
        </div>
        <div class="entry">
            <label>Severity</label>
            <select name="severity">
                <option value="Mild" selected="selected">Mild</option>
                <option value="Severe">Severe</option>
            </select>
        </div>
        <div class="entry">
            <label>Note</label>
            <textarea name="note" rows="5" cols="45"></textarea>
        </div>
        <div class="entry">
            <label> </label>
            <input type="submit" value="Send"/>
        </div>
    </form>

</div>
</center></body>
</html>
